Descreva o achado como no laudo. A resposta aponta uma das categorias publicadas, com a probabilidade e o trecho que a decide.
Categorias
Reescritas a partir da fonte e citadas
I
1 de 5
Grade I (0-25%)
Anterior translation of the slipped vertebra measuring roughly 1% to 25% of the adjacent vertebral body width. A low-grade slip (Grade I-II = under 50%).
CondutaNonoperative care is first-line for low-grade slips: activity modification, physical therapy/core strengthening, and analgesia. Surgery (decompression usually combined with fusion) is reserved for persistent pain refractory to conservative treatment, neurologic deficit, or progressive slip; only about 10%-15% of younger low-grade patients fail conservative management and need surgery.
RiscoLow-grade slips generally have a favorable prognosis with lower likelihood of progression than high-grade slips; most are managed successfully without surgery.
verificadoSpondylolisthesis (Meyerding grading)StatPearls NBK430767, Treatment/Management ('Nonoperative management is the first-line approach'; surgery for refractory pain, neurologic deficit, or progressive deformity; 'In low-grade cases, decompression, usually combined with fusion, is the standard surgical approach'; '10% to 15% of younger patients with low-grade spondylolisthesis will fail conservative treatment'). Grade I band corroborated by Wikipedia 'Spondylolisthesis', Severity (Grade I 0-25%).
II
2 de 5
Grade II (25-50%)
Anterior translation of the slipped vertebra measuring roughly 26% to 50% of the adjacent vertebral body width. Still a low-grade slip (Grade I-II = under 50%).
CondutaAs for Grade I: nonoperative management first-line, with decompression plus fusion reserved for refractory pain, neurologic deficit, or documented progression. The 50% slip boundary (between Grade II and III) marks the conventional transition from low-grade to high-grade and is a prognostically meaningful threshold.
RiscoLow-grade prognosis; lower progression risk than high-grade disease, though slips approaching the 50% threshold warrant monitoring for progression.
verificadoSpondylolisthesis (Meyerding grading)StatPearls NBK430767, Treatment/Management (same low-grade nonoperative-first, decompression+fusion approach); low-grade vs high-grade boundary at ~50% per Evaluation/management discussion. Grade II band corroborated by Wikipedia 'Spondylolisthesis', Severity (Grade II 25-50%).
III
3 de 5
Grade III (50-75%)
Anterior translation of the slipped vertebra measuring roughly 51% to 75% of the adjacent vertebral body width. A high-grade slip (Grade III-V = over 50%).
CondutaHigh-grade slips are more likely to require surgery (decompression with instrumented fusion); reduction techniques are considered, particularly when there is an unbalanced/decompensated spinopelvic alignment. Nonoperative care may still be trialed for the asymptomatic or mildly symptomatic patient, but the surgical threshold is lower than for low-grade disease.
RiscoHigh-grade spondylolisthesis carries a more guarded prognosis owing to a higher likelihood of progression and of complications.
verificadoSpondylolisthesis (Meyerding grading)StatPearls NBK430767, Treatment/Management ('High-grade spondylolisthesis carries a more guarded prognosis due to the higher likelihood of progression and complications'; reduction 'strongly considered if a superimposed unbalanced spine is noted'). Grade III band corroborated by Wikipedia 'Spondylolisthesis', Severity (Grade III 50-75%).
IV
4 de 5
Grade IV (75-100%)
Anterior translation of the slipped vertebra measuring roughly 76% to 100% of the adjacent vertebral body width. A high-grade slip (Grade III-V = over 50%).
CondutaHigh-grade management as for Grade III: instrumented decompression and fusion, with reduction considered for spinopelvic imbalance. Surgical correction of severe high-grade slips is technically demanding with higher complication rates.
RiscoGuarded prognosis with higher progression and complication risk characteristic of high-grade slips.
verificadoSpondylolisthesis (Meyerding grading)StatPearls NBK430767, Treatment/Management (high-grade guarded prognosis, reduction for unbalanced spine). Grade IV band corroborated by Wikipedia 'Spondylolisthesis', Severity (Grade IV 75-100%).
V
5 de 5
Grade V, spondyloptosis
Slip greater than 100%, where the vertebra has fully translated off the one below it (spondyloptosis). The most severe high-grade slip.
CondutaSpondyloptosis is essentially a surgical problem: instrumented fusion with reduction or, in selected cases, vertebrectomy techniques are used to restore alignment. Carries the highest technical difficulty and complication profile.
RiscoMost guarded prognosis of the grades, with the greatest deformity, neurologic risk, and surgical complication potential.
verificadoSpondylolisthesis (Meyerding grading)StatPearls NBK430767, Treatment/Management (high-grade guarded prognosis and reduction considerations apply to the most severe slips). Grade V band corroborated by Wikipedia 'Spondylolisthesis', Severity (Grade V >100%).
Lógica de decisão estruturada
{
"categories": [
"I",
"II",
"III",
"IV",
"V"
]
}
Referência, não é dispositivo médico. Confira a publicação primária vigente. O radiologista que assina o laudo continua autor e responsável.